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The South Asian Cochrane Network

The South Asian Cochrane Network. Dr. Prathap Tharyan MD, MRCPsych Professor of Psychiatry Editor, Cochrane Schizophrenia Group Coordinator, South Asian Cochrane Network Prof. BV Moses Centre for Research and Training in Evidence Based Health Care Christian Medical College, Vellore, India.

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The South Asian Cochrane Network

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  1. The South Asian Cochrane Network Dr. Prathap Tharyan MD, MRCPsych Professor of Psychiatry Editor, Cochrane Schizophrenia Group Coordinator, South Asian Cochrane Network Prof. BV Moses Centre for Research and Training in Evidence Based Health Care Christian Medical College, Vellore, India

  2. EVIDENCE BASED MEDICINE • “Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values” (Sackett, et al 2001)

  3. Why do we need EBM? Wherever health care is provided and used, it is essential to know which interventions work, which do not work, and which are likely to be harmful. This is especially important in situations where health problems are severe and the scarcity of resources makes it vital that they are not wasted EBM has a particular relevance to the developing world

  4. The chronology of an infection • Bitten by the Cochrane bug (Clive Adams) in 1995,in Oxford, UK • Protocol for systematic review published in Issue 1, 1996 • Review published in Issue 1, 1997 • Updated twice, in 2002 and 2005

  5. An April Fool’s Day joke? • Kenneth Warren Prize 2002 • Cochrane Colloquium in Stavanger

  6. Attending Cochrane Colloquia may be fatal to your free time in years to come Statutory Warning!

  7. The Cochrane Collaboration Collaborative Review Groups Centres Steering Group Methods Groups Fields The Consumer Network

  8. Cochrane Centres Canadian Nordic German UK San Francisco Dutch Chinese Italian Iberoamerican Chinese SACN New England Thai Cochrane Network Brazilian Australasian South African NZBranch

  9. Exploratory meeting: Goa December 2004

  10. South Asian Cochrane Network Exploratory meeting at Goa; December 2004

  11. The South Asian Cochrane Network

  12. Network Sites in India Chandigargh Delhi Mumbai Manipal Chennai Vellore

  13. www.cochrane-sacn.org

  14. Prof BV Moses Centre for Clinical Trials & EBM

  15. Network Sites in Pakistan

  16. Network Site in Sri Lanka Ragama

  17. Network Site in Bangladesh

  18. Goals of the SACN • Goal 1: To raise awareness about the Cochrane Collaboration and evidence based practice in South Asia • Goal 2: To train and support contributors to the Cochrane Collaboration in South Asia • Goal 3: To promote access to The Cochrane Library for South Asia • Goal 4: To ensure a sustainable structure for the South Asian Cochrane Network • Goal 5: To represent and advocate for high quality research in South Asia

  19. To train and support contributors to the Cochrane Collaboration in South Asia Protocol Development Workshop CMC Vellore, July 2004

  20. Protocol Development Workshop, Aga Khan University, Karachi, April 2006

  21. Sensitization workshops • 18 in different parts of India, Sri Lanka since 2005 Post Graduate Institute; Colombo Dec 05

  22. Review Completion workshops

  23. SACN participation in systematic reviews (Issue 3, 2005)

  24. SACN participation in systematic reviews (Issue 3, 2006)

  25. Growth of contributors in India

  26. The Cochrane Collaboration’s response to the tsunami, 2004

  27. Nagapattinam District • 73 affected villages • 1,96,184 population • 36,860 homes • 6053 human lives lost • 5023 livestock perished • 40 relief camps • 36,664 people in camps

  28. Evidence for interventions to be used after disasters? Media pressure to provide counselling to survivors

  29. Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Cochrane Review). Rose S, Bisson J, Wessely S. In: The Cochrane Library, Issue 4, 2003.

  30. Brief single session debriefing increases odds of PTSD in long term

  31. The Cochrane Collaboration & the Asian tsunami • Tsunami working group • Free country-wide access to the Cochrane Library to all affected countries • Evidence based summaries of relevant effective interventions • List of priority reviews that need updating • List of interventions that need to be reviewed www.cochrane.org

  32. Usage statistics of The Cochrane Library (Jan-June 2005)

  33. Dissemination of Evidence Aid • Ministry of Health • Indian Council of Medical Research • Director General of Health Services • Non-governmental aid agencies • Following the Mumbai floods • Following the earthquake inPakistan and Kashmir

  34. Influencing health policy in India • Workshop for senior faculty of the Indian Council of Medical Research (ICMR) (October 10, 2006) • Using Cochrane reviews to inform health policy and care

  35. Primaquine for preventing relapses in people with Plasmodium vivax malariaGalappaththy GN L, Omari AAA, Tharyan P. Cochrane Database for Systematic Reviews Issue 1, 2007 • Background • Plasmodium vivax infections contribute to a significant proportion of the malaria infections in many countries. Primaquine is the most widely used drug for treating the dormant liver stage. Different primaquine dosing regimens are in use. • WHO recommends 15 days of Primaquine following chloroquine; India recommends 5 days of primaquine following chloroquine • Objectives • To compare primaquine regimens for preventing relapses in people with P. vivax malaria.

  36. Search strategy • We searched the Cochrane Infectious Diseases Group's Specialized Register (January 2006), CENTRAL (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to October 2006), EMBASE (1974 to January 2006), LILACS (1982 to January 2006), conference proceedings and reference list of articles. We also contacted researchers, the World Health Organization, malaria mailing lists, and selected pharmaceutical companies.

  37. Selection criteria • Randomised and quasi-randomised controlled trials comparing (1) primaquine plus chloroquine with chloroquine alone and (2) the standard primaquine regimen (15 mg/day for 14 days) with other regimens containing primaquine in people with P. vivax malaria. • Data collection & analysis • All authors independently assessed trial eligibility and quality, and extracted data. We calculated odds ratios (OR) with 95% confidence intervals (CI) for dichotomous data, and used the random effects model if there was significant heterogeneity.

  38. Main results • Nine RCTs (3423 participants) met the inclusion criteria. • Most from India • Pakistan, Afganistan, Thailand

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